胆道压力监测技术在肝内外胆管结石腹腔镜下胆道取石术中的应用价值

Application Value of Bile Duct Pressure Monitoring Technology in Laparoscopic Choledocholithotomy for Intrahepatic and Extrahepatic Bile Duct Stones

目的:探讨胆道压力监测技术在肝内外胆管结石腹腔镜下胆道取石术中的应用价值。方法:选取笔者所在医院2017年1月-2021年3月收治的肝内外胆管结石患者47例,将其随机分为研究组(22例)和对照组(25例)。对照组行腹腔镜下胆道取石术,研究组在对照组的基础上于术中应用胆道压力监测技术。比较两组手术时间、术中出血量、住院时间、肝功能指标、炎症水平及术后并发症发生率。结果:研究组手术时间长于对照组,差异有统计学意义(P<0.05)。两组术中出血量及住院时间比较差异无统计学意义(P>0.05)。术后,两组谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBIL)水平均较术前升高,但研究组ALT、AST、TBIL水平均低于对照组(P<0.05)。术后两组白细胞、C反应蛋白水平均较术前降低,且研究组均低于对照组,差异有统计学意义(P<0.05)。术后1个月,两组并发症发生率比较差异无统计学意义(P>0.05)。结论:在肝内外胆管结石腹腔镜下胆道取石术中应用胆道压力监测技术,能有效减轻对患者肝功能的损伤及炎症反应,术后并发症较少,安全性较高。

Objective:To investigate the application value of bile duct pressure monitoring technology in laparoscopic choledocholithotomy for intrahepatic and extrahepatic bile duct stones.Method:A total of 47 patients with intrahepatic and extrahepatic bile duct stones admitted in our hospital from January 2017 to March 2021 were selected and randomly divided into the study group (n=22) and the control group (n=25).The control group underwent laparoscopic choledocholithotomy,and the study group applied intraoperative bile duct pressure monitoring technology on the basis of the control group.The operation time,intraoperative blood loss,hospitalization time,liver function index,inflammation level,and postoperative complication rate were compared between the two groups.Result:The operation time of the study group was longer than that of the control group,the difference was statistically significant (P<0.05).There were no significant differences in intraoperative blood loss and hospitalization time between the two groups (P>0.05).After surgery,the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBIL) in the two groups were increased compared with those before surgery,but the levels of ALT,AST and TBIL in the study group were lower than those in the control group,the differences were statistically significant (P<0.05).The levels of white blood cells and C-reactive protein in the two groups were lower than those before surgery,and the study group was lower than the control group,the differences were statistically significant (P<0.05).One month after surgery,there was no significant difference in the incidence of complications between the two groups (P>0.05).Conclusion:The application of bile duct pressure monitoring technology in laparoscopic choledocholithotomy for intrahepatic and extrahepatic bile duct stones can effectively reduce the injury of liver function and inflammatory reaction of patients,with less postoperative complications and higher safety.